Cardiovascular disease (CVD) is the leading cause of death and major disability in older adults, and approximately 85% of all cardiovascular deaths in the U.S. occur in persons over 65 years of age. Moreover, although major advances over the past 30 years have led to greatly enhanced understanding of cardiovascular diseases in the elderly, critically important questions remain unanswered. The Pivotal Research in Cardiovascular Syndromes in the Elderly (PRICE) conference series was conceived in 1999 as a mechanism to concisely review state-of-the-art knowledge, identify critical gaps in that knowledge, and define a prioritized agenda for cardiovascular aging research in the ensuing 5-10 years. PRICE-1 (1999) provided an overview of major topics, with the expectation that subsequent PRICE symposia would explore specific topics in greater detail. Accordingly, PRICE-2 (2002) focused on acute coronary syndromes in the elderly, and the present proposal requests support for PRICE-3 (2004), PRICE-4 (2006), and PRICE-5 (2008), which will address heart failure, electrophysiology and rhythm disorders, and preventive cardiology, respectively. Specific aims for each PRICE conference include: 1. convene an international cadre of distinguished scientists and clinical investigators to define the current knowledge base and identify key gaps in knowledge that should serve as targets for future research; 2. foster interdisciplinary collaborations to enhance understanding of the complex interactions between aging and CVD; 3. stimulate career interests and development of promising young investigators; and 4. widely disseminate the conference's findings, including a broad-based but prioritized research agenda in each of the major topic areas. These objectives will be accomplished through a structured series of presentations and discussions addressing key topics ranging from molecular biology and genetics to epidemiology, clinical trials, and geriatrics. A Young Investigator Travel Award Program will provide support for attendance by qualified young investigators, and specific efforts will be made to engage women and minority group members at all levels of participation. Significance. CVD is an enormous public health problem in the U.S., and the magnitude of this problem is likely to increase exponentially as the population ages over the next several decades. It is therefore essential to accelerate the pace of research in cardiovascular aging and CVD in the elderly, and the PRICE series of conferences will provide specific recommendations regarding potentially fruitful avenues of investigation that are likely to have the greatest impact in advancing understanding of the fundamental mechanisms responsible for cardiovascular aging and in improving clinical care and outcomes for older adults with CVD.